Abstract
Background: Limitation to daily physical activity (PA) is common in Intensive Care Unit (ICU) survivors. We assessed PA, primary care costs (PCC) and Quality-Adjusted Life Years (QALYs) in ICU survivors.
Methods:Subjects were drawn from the Musculoskeletal Ultrasound Study in Critical Care: Longitudinal Evaluation Study (Clinical Trials.gov Identifier: NCT01106300), all invasively ventilated for >48 hours and on ICU >7days. We assessed PA (accelerometry [Sensewear Pro, BodyMedia Inc, Pittsburgh, USA] and SF-36 survey [QualityMetric, Lincoln, USA]), QALYs (SF-6D conversion) and PCC (2009-2010; Personal Social Services Research Unit report) 18 months post-ICU discharge.
Results: 27 patients were studied (14 female; mean±SEM age 56.6±3.6 years; post-ICU discharge 576±190 days). Median Physical Function domain scores (SF-36) and accelerometry-derived daily steps were highly correlated (r=0.69;p<0.01), and lower than those from normal controls. Cumulative PCC in the 18-months post-ICU discharge were 5-fold higher for ICU survivors than for normal controls (mean±SEM: £1210±274,£238±11;p=0.0025) and QALYs lower (mean±SEM: 0.92±0.045, 1.16±0.01;p=2.48x10-6). Multiple regression indicated that Physical and Mental Component Summary scores (SF-36) contributed significantly to QALYs (r2=0.64,0.62;p=0.0005; β=0.55,0.51;p=0.001), and daily steps weakly (r2=0.07;NS). PCC showed a weak inverse association with QALYs (r2=0.14;NS).
Conclusions: Both subjective and objective measures suggest that PA and QALYs are reduced at 18 months in ICU survivors; healthcare costs are higher. Impaired PA may contribute to reduced QALYs.
- © 2014 ERS